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General NPI Number Information
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NPI Number | 1952653768
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Entity Type | Individual
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Provider Name | CYNTHIA MARIE LARSEN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 12/25/2020
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Provider Practice Location Address
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Address Line | 19231 36TH AVE W STE K
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City | LYNNWOOD
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State | WA
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Zip | 98036-5763
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Country | US
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Telephone | 425-774-9564
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Fax |
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Provider Business Mailing Address
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Address Line | 13502 106TH DR SE
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City | SNOHOMISH
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State | WA
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Zip | 98296-8245
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Country | US
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Telephone | 360-668-6908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 00001530
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License Number State | WA
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